From November 1, 2025, Australian general practice enters a new era with the introduction of the Bulk Billing Practice Incentive Program (BBPIP). As healthcare professionals across the country weigh their options, understanding what these changes mean for practices, GPs, and patients has never been more critical.
What Is the Bulk Billing Practice Incentive Program?
The Australian Government’s bulk billing reform represents the most significant shift in general practice funding in recent years. The BBPIP introduces two major changes to Medicare bulk billing incentives:
First, bulk billing incentives (BBI), previously limited to children under 16 and concession card holders, will now extend to all Medicare-eligible patients attending any general practice across Australia, for eligible MBS services that are bulk-billed.
Second, BBPIP participating practices (which have voluntarily registered to join BBPIP) receive an additional 12.5% incentive payment on eligible MBS benefits, split evenly between the GP and the practice1. BBPIP Participating Practices must commit to all their GPs bulk billing every eligible MBS service for every Medicare-eligible patient. This all-or-nothing approach is generating considerable debate within the general practice sector.
BBPIP Eligibility and Requirements
To participate in the Bulk Billing Practice Incentive Program, practices must:
- Voluntarily Register with MyMedicare to join the BBPIP (non-NGPA accredited practices exempt from accreditation requirements)
- Ensure that all their GP participate
- Bulk-bill all eligible MBS services for every Medicare-eligible patient
- Advertise participation on Healthdirect Australia’s National Health Services Directory
- Display Medicare Bulk Billing Practice signage on-site
- Register through Services Australia’s Organisation Register from November 1, 2025¹
Financial Impact: What GPs and Practices Can Expect
Health Minister Mark Butler projects that nine out of ten GP visits will be bulk billed by 2030 under BBPIP.² The government estimates approximately 4,800 practices will be financially better off adopting full bulk billing compared to their current mixed billing models.¹
However, recent Royal Australian College of GPs (RACGP) survey data reveals current challenges:
- Only 12% of GPs can afford to bulk bill all patients
- Average gap fee is $39 for standard consultations
- 50% of GPs charge $90 or more for short appointments³
Many practice managers question whether the 12.5% bulk billing incentive (which is split evenly between GPs and the practice and is not CPI indexed) covers rising operational costs including staff wages, rent, equipment, and compliance expenses.
Mental Health Medicare Item Changes
The 1st November 2025 changes also eliminate specific MHTP review and mental health consultation items, requiring GPs to use standard time-based Medicare item numbers instead.² This affects practices that previously used “co-billing” strategies, charging privately for one condition while bulk billing mental health items.
For patients with complex mental health needs, this change may result in higher out-of-pocket costs or reduced consultation times.
Additionally, referrals for treatment will be linked to a patient’s MyMedicare practice or usual GP, strengthening the patient-provider relationship and continuity of care.
GP Perspectives: Bulk Billing vs Mixed Billing in 2025
The RACGP survey shows GPs increasingly manage conditions typically handled by specialists, with longer appointment times becoming standard, particularly for mental health consultations.³
Dr Owen Harris, a Melbourne GP specialising in complex care, highlights the challenge: “There is simply no way to sustain empathy, compassion and concentration seeing that many patients in a day. Burnout or more superficial care is almost guaranteed.”²
Current Medicare rebate structures incentivise “six-minute medicine” rather than comprehensive care, creating tension between financial viability and quality patient outcomes.²
Practice Manager Decisions: To Join BBPIP or Not?
The general response from Practice Managers from many practices operating under mixed billing models remain hesitant to transition back to full bulk billing. Key concerns include:
Business Risk: Since bulk billing incentives exist as separate Medicare item numbers rather than base consultation fee increases, they can be removed at any time
Operational Challenges: Full bulk billing creates rapidly filling appointment books with limited capacity for urgent presentations or complex cases requiring longer consultations
Investment in Change: Practices that educated patients about private fees are reluctant to reverse course, citing concern if government policies change again.
Regional and Demographic Variations
Practice responses to BBPIP vary significantly based on:
- Location: Lower socioeconomic areas view BBPIP as welcome financial support for accessible care
- Patient demographics: Practices serving disadvantaged communities align naturally with full bulk billing models
- Service offerings: Specialised practices express greater scepticism about BBPIP viability
- Existing billing models: Always-bulk-billing practices welcome additional support; mixed billing practices remain cautious
BBPIP Calculator and Resources
The Australian Government provides a Bulk Billing Incentives Calculator to help practices estimate potential payments, though early users report results don’t always align with practice-specific circumstances.
Practice teams should review:
What This Means for Australian General Practice
The Bulk Billing Practice Incentive Program represents a significant Medicare policy shift with far-reaching implications. For practices already bulk billing or serving financially disadvantaged communities, BBPIP offers genuine support. For others, the incentives may not justify operational challenges and business risks.
As the November 1 start date approaches, practice teams must conduct thorough financial analyses specific to their circumstances, consult with their GPs and colleagues, and carefully evaluate whether BBPIP aligns with their practice’s culture, sustainability goals and patient care standards.
The coming months will reveal whether BBPIP achieves its goal of improving access to affordable GP care and the financial sustainability of general practices across Australia.
References
- Australian Government Department of Health and Aged Care. (2025). Upcoming changes to bulk billing incentives in general practice.
- Cockburn, P. (2025, September 30). Bulk-billing rates remain low as GPs spend longer with patients, survey finds. ABC News.
- Royal Australian College of General Practitioners. (2025). General Practice: Health of the Nation 2025. RACGP Annual Survey.
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